Healthcare Provider Details

I. General information

NPI: 1821083056
Provider Name (Legal Business Name): LYNDON CLARENCE CAPON ARNP, ND, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N OLYMPIC AVE
ARLINGTON WA
98223-1244
US

IV. Provider business mailing address

11722 TULARE WAY W. MARYSVILLE
MARYSVILLE WA
98271
US

V. Phone/Fax

Practice location:
  • Phone: 425-280-2802
  • Fax: 434-322-4336
Mailing address:
  • Phone: 425-280-2848
  • Fax: 434-322-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00112784
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00000478
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30006112
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: